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基于互联网的引导式自助问题解决疗法对青少年抑郁和焦虑的疗效:一项随机对照试验。

Effects of Internet-based guided self-help problem-solving therapy for adolescents with depression and anxiety: a randomized controlled trial.

机构信息

Department of Clinical Psychology, VU University, Amsterdam, The Netherlands.

出版信息

PLoS One. 2012;7(8):e43485. doi: 10.1371/journal.pone.0043485. Epub 2012 Aug 31.

Abstract

BACKGROUND

Symptoms of depression and anxiety are highly prevalent in adolescence and they are the cause of considerable suffering. Even so, adolescents are not inclined to seek professional help for emotional problems. Internet-based preventive interventions have been suggested as a feasible method of providing appropriate care to adolescents with internalizing symptoms. The objective of this study was to evaluate the effects of preventive Internet-based (guided) self-help problem-solving therapy (PST) for adolescents reporting mild to moderate symptoms of depression and/or anxiety as compared to a waiting list control group (WL).

METHODOLOGY/PRINCIPAL FINDINGS: A total of 45 participants were randomized to the 2 conditions. PST consisted of 5 weekly lessons. Participants were supported by e-mail. Self-report measures of depression and anxiety were filled in at baseline and after 3 weeks, 5 weeks, and 4 months. Of the 45 participants, 28 (62.2%) completed questionnaires after 3 weeks, 28 (62.2%) after 5 weeks, and 27 (60%) after 4 months. Hierarchical linear modeling analyses revealed overall improvement over time for both groups on depressive and anxiety symptoms. However, no significant group x time interactions were found. No differences were found between completers and non-completers.

CONCLUSIONS/SIGNIFICANCE: Results show that depressive and anxiety symptoms declined in both groups. No support was found, however, for the assumption that Internet-based PST was efficacious in reducing depression and anxiety in comparison to the waiting list control group. This finding could represent lack of power.

TRIAL REGISTRATION

Netherlands Trial Register NTR1322.

摘要

背景

抑郁和焦虑症状在青少年中非常普遍,是造成相当大痛苦的原因。即便如此,青少年并不倾向于寻求专业帮助来解决情绪问题。基于互联网的预防干预措施被认为是为有内化症状的青少年提供适当护理的一种可行方法。本研究的目的是评估针对报告有轻度至中度抑郁和/或焦虑症状的青少年的预防型基于互联网(指导)自助问题解决疗法(PST)与等待名单对照组(WL)相比的效果。

方法/主要发现:共有 45 名参与者被随机分配到 2 个条件。PST 包括 5 周的课程。参与者通过电子邮件获得支持。在基线和 3 周、5 周和 4 个月后填写抑郁和焦虑的自我报告量表。在 45 名参与者中,有 28 名(62.2%)在 3 周后完成了问卷,28 名(62.2%)在 5 周后完成了问卷,27 名(60%)在 4 个月后完成了问卷。层级线性建模分析显示,两组在抑郁和焦虑症状上均随着时间的推移而有所改善。然而,没有发现组间时间的显著交互作用。完成者和未完成者之间没有差异。

结论/意义:结果表明,两组的抑郁和焦虑症状均有所下降。然而,没有证据支持基于互联网的 PST 与等待名单对照组相比能有效降低抑郁和焦虑的假设。这一发现可能代表着缺乏效力。

试验注册

荷兰试验注册 NTR1322。

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